Alternative liver transplant options
Get a better understanding of alternative liver transplant options and which may be right for you.
You can watch the full liver video series on YouTube.
All liver transplant options come with benefits and risks, and not every transplant option is the right choice for all patients.
Risks of donation options
The quality of organs from the waitlist vary and come with their own risks, but you may get a transplant sooner if you accept these risks.
There may also be less waiting and a smaller chance of you getting sick while waiting. You can always turn down different options and it will not negatively affect your care, but it will increase your wait time for a transplant. Before selecting the best option for you, you will sign a consent form so organs can be offered to you once you are listed.
Alternative liver transplant options
Risk criteria liver donors are donors who have a potential risk for three infections: human immunodeficiency virus (HIV), hepatitis B (HBV), or hepatitis C (HCV). Almost all recipients should consider this option.
All liver donors, deceased and living, are tested for common transmissible viruses, like HIV, HBV, and HCV. Most liver donors are negative, but there are some organ donors that are thought to have a higher risk of transmitting these viruses and still test negative for them. The overall risk of a virus being passed from one of these donors is very low.
Risk criteria donor behaviors
The public health service defines risk criteria liver donors as donors with at least one of the following behaviors within three months before donation.
- Injecting drugs for nonmedical reasons
- Incarceration for more than 72 hours
- A man who has had sex with another man
- Sex in exchange for money
- Sex with a person known to have HIV, HBV, or HCV
- Donors with unknown medical histories
Factors to consider
- It is very rare to get infected with HBV or HCV, and both can be cured or controlled by taking medicine. Regardless of the donor, all recipients are tested for viral infections during the first year after transplant.
- Most of these organs come from donors that tend to be younger and healthier than the average donor you might be offered organs from.
- If you don’t accept a risk criteria organ, the other option is to stay on the wait list until a different organ is available. This comes with its own risks, and you don’t know when the next organ will be available.
Another option is accepting a liver from a donor previously infected with hepatitis B (HBV) or hepatitis C (HCV). Some of these donors have gotten rid of the virus and some are still actively infected. These can still be excellent donors.
Advantage: Get transplanted quicker.
Disadvantages: You will likely need to take oral medicines to prevent or treat an infection. These medicines are very effective, and the risk of transmission can be very low. An infection can still occur and if not successfully treated, can cause hepatitis or inflammation of the liver, which can lead to cirrhosis (severe scarring of the liver).
All potential transplant candidates are tested for prior exposure during the evaluation process to decide if this option is good for you. Your care team may also recommend certain vaccines before transplantations that may affect your choice.